The versatile roles of long non-coding RNAs in kidney disease

Long non-coding RNAs (lncRNAs) have emerged as critical regulators of kidney homeostasis, and their dysregulation has been implicated in a wide range of kidney diseases including acute kidney injury, chronic kidney disease and renal cell carcinoma, as well as in age-related kidney dysfunction. Increasing evidence indicates that lncRNAs have roles in key cellular processes including inflammation, autophagy, cell proliferation, senescence, apoptosis, mitochondrial dysfunction, angiogenesis, epithelial-mesenchymal transition and interstitial fibrosis. LncRNAs interact with RNA, DNA and protein to regulate gene expression via multiple mechanisms, including RNA modifications, scaffold assembly, chromatin remodelling, transcription and post-transcriptional control. Beyond their non-coding functions, some lncRNAs can be translated into bioactive micropeptides that further modulate cellular activity. Given their tissue-specific expression and high stability in body fluids, lncRNAs hold promise as biomarkers for early detection and monitoring of kidney diseases. Furthermore, lncRNA-based therapies offer novel opportunities to halt disease progression in chronic kidney disease and overcome drug resistance in renal cell carcinoma. Improved understanding of lncRNA-mediated disease mechanisms could therefore lead to improvements in the diagnosis and treatment of kidney pathologies.